The aims of this study were to assess the epidemiology of M. pneumoniae respiratory tract infections in Slovenian patients during a 10-year period, to recognize which genotypes were present in the study population and to investigate if different genotypes show diverse in vitro pathogenicity potentials. We analysed the results from routine diagnostics for the detection of M. pneumoniae and used stored M. pneumoniae isolates for genotyping (P1 typing and MLVA). Five genotypes were used for in vitro infection of A549 cells in order to determine bacterial growth, cytotoxicity and pro-inflammatory cytokine (IL-1β, IL-6, IL-8, TNF-α and IFN-γ) production. The results showed that in the period from 2006 to 2015 two distinct epidemics occurred (2010/11 and 2014/15) and that the dominant P1 type shifted from P1 type 2 to P1 type 1 just prior to the second epidemic. All together we detected nine MLVA genotypes from which three (MLVA-3,5,6,2; MLVA-3,6,6,2 and MLVA-4,5,7,2) were present during the whole study period and represented 95.2 % of isolates. We found no differences in bacterial growth dynamics or cytotoxicity for five selected MLVA genotypes. The host cells responded to all genotypes except MLVA-3,5,6,2 by producing IL-1β, IL-6 and IL-8 but not TNF-α or IFN-γ. For the genotype MLVA-3,5,6,2 we observed an inhibition of IL-6 production and more than half less IL-8 response. These results may indicate a possible impact of bacterial genotype on the immune response of host cells.
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